The slow crippling disease of the spine?

Dr. Biodun Ogungbo

Alhaji B.A. is a 75-year-old gentleman who was rushed to Abuja for urgent operation on his neck. He had slowly become crippled in his own house. He woke up one day to find he was unable to get out of bed. His hands and legs had slowly stopped working and he was in deep trouble.

He also had neck pains, pains shooting into the arms, hands, numbness in the hands and feet as well as difficulty walking. Over the past few weeks before everything went really bad, he had noticed progressive unsteadiness when walking. Initially, he started using a stick for support, then two sticks before even those failed to keep him upright.

The problem was arthritis of the bones in his neck, causing pressure and damaging his spinal cord. The pressure was preventing his hands and legs from working and so was paralysing him. He had been to several hospitals and everyone kept telling him to go to India. However, the cost of travelling to India, the anticipated difficulty for a sick elderly man, the length of the journey and many more uncertainties led him to continue the search for a local solution.

And, yes, there is a local solution — right here in Abuja, Nigeria!

Cervical spondylosis

Cervical is the medical term for neck. Spondylosis is a term referring to degenerative arthritis of the joints between the bones. Therefore, cervical spondylosis is arthritis of the neck. It can cause pain in the neck, radiating into the head, pain shooting down the arms and pain down the spine. It can lead to pressure on the nerves or the spinal cord. This can then cause numbness in the hands, legs and difficulty with walking. It can be so bad as to make a patient completely disabled.

Treatment

•Prevention of neck problems by avoiding the common causes as above

•Neck exercises and physiotherapy (including massage and use of cervical collars)

•Using drugs as prescribed by the doctor (paracetamol and anti-inflammatory drugs)

Drug treatment

•Ibuprofen

•Diclofenac

•Tramadol

•Steroids like Prednisolone are not recommended treatment for back or neck pains. This is very important information for doctors and patients alike. No one should prescribe steroids for neck or back pains. It does more harm than good.

Spine: Fixed in Abuja

Operations on the spine are performed for a variety of reasons. These ranges from degenerative arthritis due to us growing older, to trauma from mainly road traffic accidents, to such conditions as tumours and spine infections, especially due to tuberculosis. The operations can be performed from the front or the back of the neck.

The spine team in Abuja offers a good range of operative and non operative treatment options in spine care. They can perform different simple and complex spine surgeries tailored to deliver the best and expected outcome for the patient. The operations are often designed to eliminate or reduce pain, to reduce or eliminate disability or both.

Post-operative care in Abuja

The usual practice is to ensure adequate pain management. The operations on the spine are pretty painful operations due to muscle dissection. We also sometimes have to shave the arthritis off the bones, so pain occurs at the end. However, nurses are quite experienced in reducing the pain which settles within two to three days. The patient is allowed to rest for a day after the operation but subsequently is actively mobilised by the physiotherapist. By the second day, the patient is allowed to move out of bed and made to walk around if possible. They are then effectively on their way home. Alhaji B.A. is already home, close to his doctor and even closer to family and friends.

What happens after surgery on the spine?

This is an important consideration, as many patients require about one week in hospital and another 4-8 weeks to recuperate. There can be complications such as pains, infection and wound healing problems that require management. It is therefore best to be close to your surgeon so timely solutions can be found for any problem. Further follow up clinic visit is also easier to arrange locally through cheap phone calls or even a return visit to Abuja.

An important consideration

Not all patients require an operation. Those who do not need an operation or for whom the risks outweigh the benefits are managed conservatively — that is, with pain killers, expert nursing care and physiotherapy. This is easier and less expensive if you find out in Nigeria and not after an exhausting trip to America! If, for example, you find you have wasted time and money travelling to another country for a condition they cannot or will not treat, the shock is enough to kill a sick patient!

So, even if you are hell bent on travelling outside Nigeria for treatment, maybe you should come to Abuja first for advice and a second or even third opinion. It may actually save you money.

Abuja is easy to reach!

We must promote local care in patients with spine problems. Abuja is in a prime central location offering easy access to all Nigerians wherever they may live. Most flights to Abuja are only about an hour long, compared to almost a days’ travel to India. Further, someone is bound to be able to speak English or even your local dialect in Abuja! The food is also whatever you want and not a strange meal.

Yes, it can be done in Nigeria; and yes, it can be done safely.